Organization
PECAN MANOR NURSING AND REHABILITATION LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A RICH (PRESIDENT)
(940) 387-4388
Entity
Organization
Contact information
Practice address
413 MANSFIELD CARDINAL RD, KENNEDALE, TX 76060-2805
(817) 561-4495
(817) 561-6033
Mailing address
401 N ELM ST, DENTON, TX 76201-4137
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115249
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004226
—
TX
01
—
153326702
TMHP (CROSS-OVER)
TX
Enumeration date
11/04/2005
Last updated
03/21/2012
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